Skip to main content
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 2/2009

01.02.2009 | Retinal Disorders

Perfluorocarbon liquid assisted large retinal epithelium patching in sub-macular hemorrhage secondary to age related macular degeneration

verfasst von: S. K. Gibran, M. R. Romano, D. Wong

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 2/2009

Einloggen, um Zugang zu erhalten

Abstract

Background

We investigate the safety and feasibility of large retinal pigmentary epithelium (RPE)-Choroid-free graft after surgical drainage of massive sub-macular hemorrhage (SMH) due to age-related macular degeneration (ARMD).

Methods

Four previously untreated patients (three females and one male) underwent to three port pars plana vitrectomy, induction of retinal detachment and peripheral temporal 180° retinotomy. The retina was then folded nasally, to allow access for removal of sub-macular Hg and CNV complex. A full-thickness-large autologus Chorio-RPE patch was grafted. Silicone oil was used as endotemponade for approximately 12 weeks. After removal of silicone oil, the patients were followed-up for 6 months.

Results

SMH was completely removed in all cases. It was possible to graft a large RPE patch safely that is sufficiently large to cover the entire defect of macular RPE. At last follow-up, improvement in visual acuity (from 3 ± 0.9 to 55 ± 9 ETDRS letters) and recovery of central fixation was observed in all patients.

Conclusions

Our surgical technique for large elevated SMH seems to be feasible and efficacious approach to harvest and relocate large RPE patch and to save limited vision in selected patients.
Literatur
1.
Zurück zum Zitat Bennett SR, Folk JC, Blodi CF, Klugman M (1990) Factors prognostic of visual outcome in patients with subretinal hemorrhage. Am J Ophthalmol 15:33–37 Bennett SR, Folk JC, Blodi CF, Klugman M (1990) Factors prognostic of visual outcome in patients with subretinal hemorrhage. Am J Ophthalmol 15:33–37
3.
Zurück zum Zitat Vander JF, Federman JL, Greven C, Slusher MM, Gabel VP (1991) Surgical removal of massive subretinal hemorrhage associated with age-related macular degeneration. Ophthalmology 98:23–27PubMed Vander JF, Federman JL, Greven C, Slusher MM, Gabel VP (1991) Surgical removal of massive subretinal hemorrhage associated with age-related macular degeneration. Ophthalmology 98:23–27PubMed
4.
Zurück zum Zitat Binder S, Krebs I, Hilgers RD, Abri A, Stolba U, Assadoulina A, Kellner L, Stanzel BV, Jahn C, Feichtinger H (2004) Outcome of transplantation of autologous retinal pigment epithelium in age-related macular degeneration: a prospective trial. Invest Ophthalmol Vis Sci 45:4151–4160. doi:10.1167/iovs.04-0118 PubMedCrossRef Binder S, Krebs I, Hilgers RD, Abri A, Stolba U, Assadoulina A, Kellner L, Stanzel BV, Jahn C, Feichtinger H (2004) Outcome of transplantation of autologous retinal pigment epithelium in age-related macular degeneration: a prospective trial. Invest Ophthalmol Vis Sci 45:4151–4160. doi:10.​1167/​iovs.​04-0118 PubMedCrossRef
5.
Zurück zum Zitat MacLaren RE, Bird AC, Sathia PJ, Aylward GW (2005) Long-term results of submacular surgery combined with macular translocation of the retinal pigment epithelium in neovascular age-related macular degeneration. Ophthalmology 112:2081–2087. doi:10.1016/j.ophtha.2005.06.029 PubMedCrossRef MacLaren RE, Bird AC, Sathia PJ, Aylward GW (2005) Long-term results of submacular surgery combined with macular translocation of the retinal pigment epithelium in neovascular age-related macular degeneration. Ophthalmology 112:2081–2087. doi:10.​1016/​j.​ophtha.​2005.​06.​029 PubMedCrossRef
6.
Zurück zum Zitat Maaijwee K, Heimann H, Missotten T, Mulder P, Joussen A, van Meurs J (2007) Retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration: long-term results. Graefes Arch Clin Exp Ophthalmol 245:1681–1689. doi:10.1007/s00417-007-0607-4 PubMedCrossRef Maaijwee K, Heimann H, Missotten T, Mulder P, Joussen A, van Meurs J (2007) Retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration: long-term results. Graefes Arch Clin Exp Ophthalmol 245:1681–1689. doi:10.​1007/​s00417-007-0607-4 PubMedCrossRef
7.
Zurück zum Zitat Van Meurs JC, Ter Averst E, Hofland LJ, van Hagen PM, Mooy CM, Baarsma GS, Kuijpers RW, Boks T, Stalmans P (2006) Autologous peripheral retinal pigment epithelium translocation in patients with subfoveal neovascular membranes. Br J Ophthalmol 88:110–113. doi:10.1136/bjo.88.1.110 CrossRef Van Meurs JC, Ter Averst E, Hofland LJ, van Hagen PM, Mooy CM, Baarsma GS, Kuijpers RW, Boks T, Stalmans P (2006) Autologous peripheral retinal pigment epithelium translocation in patients with subfoveal neovascular membranes. Br J Ophthalmol 88:110–113. doi:10.​1136/​bjo.​88.​1.​110 CrossRef
8.
Zurück zum Zitat Chen FK, Uppal GS, Rubin GS, Webster AR, Coffey PJ, Da Cruz L (2008) Evidence of retinal function using microperimetry following autologous retinal pigment epithelium-choroid graft in macular dystrophy. Invest Ophthalmol Vis Sci 49:3143–3150. doi:10.1167/iovs.07-1648 PubMedCrossRef Chen FK, Uppal GS, Rubin GS, Webster AR, Coffey PJ, Da Cruz L (2008) Evidence of retinal function using microperimetry following autologous retinal pigment epithelium-choroid graft in macular dystrophy. Invest Ophthalmol Vis Sci 49:3143–3150. doi:10.​1167/​iovs.​07-1648 PubMedCrossRef
9.
Zurück zum Zitat Treumer F, Bunse A, Klatt C, Roider J (2007) Autologous retinal pigment epithelium-choroid sheet transplantation in age related macular degeneration: morphological and functional results. Br J Ophthalmol 91:349–353. doi:10.1136/bjo.2006.102152 PubMedCrossRef Treumer F, Bunse A, Klatt C, Roider J (2007) Autologous retinal pigment epithelium-choroid sheet transplantation in age related macular degeneration: morphological and functional results. Br J Ophthalmol 91:349–353. doi:10.​1136/​bjo.​2006.​102152 PubMedCrossRef
10.
11.
Zurück zum Zitat MacLaren RE, Uppal GS, Balaggan KS, Tufail A, Munro PM, Milliken AB, Ali RR, Rubin GS, Aylward GW, da Cruz L (2007) Autologous transplantation of the retinal pigment epithelium and choroid in the treatment of neovascular age-related macular degeneration. Ophthalmology 114:561–570. doi:10.1016/j.ophtha.2006.06.049 PubMedCrossRef MacLaren RE, Uppal GS, Balaggan KS, Tufail A, Munro PM, Milliken AB, Ali RR, Rubin GS, Aylward GW, da Cruz L (2007) Autologous transplantation of the retinal pigment epithelium and choroid in the treatment of neovascular age-related macular degeneration. Ophthalmology 114:561–570. doi:10.​1016/​j.​ophtha.​2006.​06.​049 PubMedCrossRef
12.
Zurück zum Zitat Machemer R, Steinhorst UH (1993) Retinal separation, retinotomy, and macular relocation: II. A surgical approach for age-related macular degeneration? Graefes Arch Clin Exp Ophthalmol 231:635–641. doi:10.1007/BF00921957 PubMedCrossRef Machemer R, Steinhorst UH (1993) Retinal separation, retinotomy, and macular relocation: II. A surgical approach for age-related macular degeneration? Graefes Arch Clin Exp Ophthalmol 231:635–641. doi:10.​1007/​BF00921957 PubMedCrossRef
13.
Zurück zum Zitat Ninomiya Y, Lewis JM, Hasegawa T, Tano Y (1996) Retinotomy and foveal translocation for surgical management of subfoveal choroidal neovascular membranes. Am J Ophthalmol 122:613–621PubMed Ninomiya Y, Lewis JM, Hasegawa T, Tano Y (1996) Retinotomy and foveal translocation for surgical management of subfoveal choroidal neovascular membranes. Am J Ophthalmol 122:613–621PubMed
Metadaten
Titel
Perfluorocarbon liquid assisted large retinal epithelium patching in sub-macular hemorrhage secondary to age related macular degeneration
verfasst von
S. K. Gibran
M. R. Romano
D. Wong
Publikationsdatum
01.02.2009
Verlag
Springer-Verlag
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 2/2009
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-008-0958-5

Weitere Artikel der Ausgabe 2/2009

Graefe's Archive for Clinical and Experimental Ophthalmology 2/2009 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.